alexa Searching for the Ideal Therapy for Cancer Cachexia | Open Access Journals
ISSN: 2329-6631
Journal of Developing Drugs
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Searching for the Ideal Therapy for Cancer Cachexia

Josep M Argilés1,2*, Francisco Javier López-Soriano1,2 and Sílvia Busquets1,2

1Cancer Research Group, Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain

2Institut de Biomedicina de la, Universitat de Barcelona, Barcelona, Spain

*Corresponding Author:
Josep M Argilés
Cancer Research Group
Departament de Bioquímica i Biomedicina Molecular
Facultat de Biologia
Universitat de Barcelona, Barcelona, Spain
Tel: +390916552500
E-mail: jargiles@ub.edu

Received Date: February 14, 2017 Accepted Date: February 16, 2017 Published Date: February 19, 2017

Citation: Argiles JM, Javier F, Soriano L, Busquets S (2017) Searching for the Ideal Therapy for Cancer Cachexia. J Dev Drugs 6: e151. doi: 10.4172/2329-6631.1000e151

Copyright: © 2017 Argilés JM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Developing Drugs

Editorial

Although megestrol acetate and corticosteroids have been, and still are, the universal drug approaches for the treatment of the cancer cachectic syndrome, novel drugs and treatments have lead to promising approaches to counteract wasting thus improving the quality of life and, possibly, survival of cancer patients. Thus, ghrelin agonists, such as anamorelin, that basically act on food intake, nonsteroidal selective androgen receptor modulators (SARMs), such as enobosarm, hold promise as a new class of anabolic therapies for cancer patients that manifest muscle wasting. In addition, betablockers can reduce body energy expenditure and improve efficiency of substrate utilization. Some of them do combine many different pharmacological effects. For instance, espindolol is a non-specific β1/ β2 adrenergic receptor antagonist that exhibits effects through β and central 5-HT1α receptors to demonstrate pro-anabolic, anti-catabolic, and appetite-stimulating actions. Finally, myostatin antagonists, such as bimagrumab or BYM338, seems to be able in pre-clinical models to prevent skeletal muscle mass loss and preserve muscle function facilitating the recovery from muscle atrophy. All of the commented drugs are certainly new promising strategies to fight cancer cachexia [1].

However, in order to improve the treatment of cancer cachexia, several considerations have to be made. First, a better understanding of the pathophysiological mechanisms related to skeletal muscle and, in general, body wasting, will enable the development of novel therapeutic approaches. Second, more research should also be devoted to biomarkers for cancer cachexia. Indeed, in many clinical centres, cancer cachexia is treated only when a significant amount of weight loss is detected, or when the patients suffer from certain limitations in daily living activities. Biomarkers could detect the changes before any clinical manifestations arouse, facilitating treatment and, possibly, improving prognosis. Progress has certainly been made concerning biomarkers [2] but more research is needed in this field to find an easy measurable --either blood or urine present-early and specific muscle wasting biomarker. Third, since cancer cachexia leads to decrease potential for muscle regeneration due to the fact that satellite cells are not able to differentiate into myocells, one new revolutionary concept that will, no doubt, involve further research is that of cell reprogramming to muscle. Therefore, future studies are needed on the potential of stem cell therapy to overcome the problem of muscle cell regeneration. While adult stem cells are tissue specific and have limited capacity to be expanded ex vivo pluripotent stem cells, have the capacity to differentiate into any cell type while possessing unlimited in vitro self-renewal. Scott et al. [3] described a methodology for largescale isolation of satellite cells from skeletal muscle. This could then be applied as a therapeutic strategy to stimulate muscle regeneration. Fourth, it is quite clear that a single drug treatment is not an appropriate approach for the treatment of muscle wasting and, in general, cancer-associated cachexia. During the last years, it has become very clear that combinations of nutrition, nutraceuticals and drugs is a much preferred therapeutic approach. In fact, the approach has to be multimodal involving, not just the combinations mentioned, but also incorporating sustainable exercise. Although this multimodal approach may be difficult to undertake into clinical practice, a casebased approach has recently been published [4]. Muscaritoli et al. [5] have defined the so-called TARGET approach which is a good way of interpreting the multimodal approach. It actually integrates active interventions and research programs related with the onset and progression of cancer cachexia. This approach includes Teaching (nutrition, metabolic alterations in cancer), Awareness (of the negative impact of cancer cachexia), Recognition (diagnosis and staging), Genetics (inherited susceptibility), Exercise (physical activity) and Treatment. The MENAC (Multimodality Exercise/Nutrition Antiinflammatory treatment for Cachexia) trial [6] also represents a good example of a multimodal approach. This on-going phase III trial is enrolling both lung, cholangio- and pancreatic carcinoma cancer patients and includes nutritional counselling, oral nutrition supplementation (including EPA), a physical exercise program and an anti-inflammatory (ibuprofen) treatment. And finally, the other key aspect to consider is the design of appropriate trials. Indeed, on-going trials have a rather heterogeneous design and include an excessively wide span of different types of tumours with different degrees of cachexia. In fact, a unified approach is requested in a recent consensus document [7]. Some of the most promising drug candidates are completely new molecules and, therefore, particular attention has to be focused on safety issues and not just side effects, but also long-term treatment associated problems, together with the issue of interaction with other drugs. This last point is particularly relevant since, as we have mentioned, the ideal treatment for cancer cachexia is multimodal, involving different drugs and nutraceuticals. Endpoints particularly primary are also something absolutely essential. Lean body mass or, even better, muscle mass together with a measurement of function, like total daily physical activity are good candidates.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Recommended Conferences

Article Usage

  • Total views: 101
  • [From(publication date):
    March-2017 - Jun 24, 2017]
  • Breakdown by view type
  • HTML page views : 79
  • PDF downloads :22
 
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

agrifoodaquavet@omicsonline.com

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

clinical_biochem@omicsonline.com

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

business@omicsonline.com

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

chemicaleng_chemistry@omicsonline.com

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsci@omicsonline.com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

engineering@omicsonline.com

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

generalsci_healthcare@omicsonline.com

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

genetics_molbio@omicsonline.com

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

immuno_microbio@omicsonline.com

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

omics@omicsonline.com

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

materialsci@omicsonline.com

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

mathematics_physics@omicsonline.com

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

medical@omicsonline.com

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psychology@omicsonline.com

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

pharma@omicsonline.com

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

social_politicalsci@omicsonline.com

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version